Critical care clinics
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Hemodynamic resuscitation for hemorrhagic shock should be directed toward optimizing oxygen delivery to the tissues. A combination of volume restoration and inotropic support usually is needed. This article identifies the basis and strategies necessary for accomplishing these goals.
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Patients with underlying medical illnesses or conditions will comprise a progressively larger proportion of head-injury patients given the aging of the general population and improved survival in serious illnesses. Age and underlying illness can influence the presentation, management, and outcome of head injuries by increasing the frequency, severity, and complications from head injury. This article examines the conditions that are most often associated with head injury.
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This article deals with the initial evaluation and management of the trauma victim, from hospital admission to stabilization. The emphasis is on the multiple-injury patient who requires lifesaving intervention within the first hour of admission, with special emphasis on trauma patients with pre-existing disease.
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The costs to society of trauma care are huge. Multiple-injury patients in critical care units consume a vast percentage of the direct medical costs. This article examines the role that pre-existing diseases have on the length of stay in the critical care unit and the costs associated with this care.
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Critical care clinics · Jul 1993
ReviewIntensive care units in the triage mode. An organizational perspective.
Decisions to admit and discharge patients to and from the intensive care unit (ICU) when resources are scarce should be made according to the triage principle--that is, resources should be allocated based on the patient's ability to benefit from critical care. The ICU organizational structure and the constraints on decision-making processes are discussed in this article along with strategies for improvement in both areas.